Influence of Reactive Balance Training Program Characteristics on Reactive Balance Control and Fall Risk: A...

Area of Science:

• Gerontology
• Rehabilitation Science
• Biomechanics

Background:

• Age-related decline in reactive balance control increases fall risk.
• Reactive Balance Training (RBT) aims to mitigate this but has variable intervention characteristics and outcomes.
• Optimal RBT delivery methods for improving balance and preventing falls are not well-defined.

Purpose of the Study:

• To systematically review and meta-analyze randomized controlled trials (RCTs) of RBT.
• To identify optimal intervention characteristics for RBT to enhance reactive balance control.
• To determine effective RBT strategies for preventing falls in daily life.

Main Methods:

• Systematic search of multiple databases (MEDLINE, Embase, PEDro, Cochrane) up to July/August 2023.
• Inclusion of RCTs reporting reactive balance control and/or falls in daily life.
• Meta-regression analysis to explore the impact of intervention features on outcomes, with Risk of Bias and GRADE assessments.

Main Results:

• 32 studies were included; 25 reported balance outcomes, 19 reported falls.
• RBT programs using manual perturbations showed reduced fall rates compared to waist-pull perturbations (RR 0.45, p=0.042).
• No other training parameters consistently correlated with improved reactive balance or reduced falls; evidence quality was low to very low.

Conclusions:

• Optimal RBT characteristics remain unclear due to significant protocol variability and underreporting in existing studies.
• Manual perturbations may be more effective for fall reduction than waist-pull methods.
• Future RBT research requires standardized, detailed protocols and reporting of both balance and fall outcomes.